Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy.
Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy.
Diabetes Res Clin Pract. 2022 May;187:109867. doi: 10.1016/j.diabres.2022.109867. Epub 2022 Apr 9.
Wider access to continuous glucose monitoring systems, including flash glucose monitoring, has enabled people with diabetes to achieve lower HbA1c levels and reduce the amount of time they spend in hypoglycaemia or hyperglycaemia, and has improved their quality of life. An International Consensus Panel proposed different target glucose ranges and recommendations according to different ages and situations (adults, young people and children with type 1 or type 2 diabetes, as well as elderly people who are at higher risk of hypoglycaemia, and women with diabetes during pregnancy). In this expert opinion, we interpret the international recommendations in the context of established clinical practice for diabetes care, and propose three different step-by-step algorithms to help the healthcare professionals use the most innovative glucose metrics, including time in glucose ranges, glucose management indicator, coefficient of variation, and ambulatory glucose profile. In detail, we focus on glucose metrics as measured by the FreeStyle Libre system and as visualized on the LibreView digital diabetes platform to support appropriate interpretation of flash glucose monitoring data. This is specifically structured for healthcare professionals and general practitioners who may have a low level of confidence with diabetes technology, with the aim of optimizing diabetes management, ensuring effective use of healthcare resources and to maximise outcomes for people with diabetes.
更广泛地使用连续血糖监测系统,包括瞬感血糖监测,使糖尿病患者能够降低 HbA1c 水平,减少低血糖或高血糖的时间,并提高生活质量。一个国际共识小组根据不同的年龄和情况(1 型或 2 型糖尿病的成年人、年轻人和儿童,以及低血糖风险较高的老年人,以及糖尿病孕妇)提出了不同的目标血糖范围和建议。在本专家意见中,我们根据既定的糖尿病护理临床实践来解释国际建议,并提出三种不同的逐步算法,以帮助医疗保健专业人员使用最创新的血糖指标,包括血糖范围内的时间、血糖管理指标、变异系数和动态血糖图谱。具体来说,我们专注于通过 FreeStyle Libre 系统测量的血糖指标以及在 LibreView 数字糖尿病平台上可视化的血糖指标,以支持对瞬感血糖监测数据的适当解释。这是专门为可能对糖尿病技术信心不足的医疗保健专业人员和全科医生设计的,目的是优化糖尿病管理,确保有效利用医疗保健资源,并最大限度地提高糖尿病患者的治疗效果。